Self-Stigma of People with Schizophrenia as Predictor of Their Adherence to Psychosocial Treatment

Objectives: Treatment non-adherence has frequently been noticed among people with schizophrenia. Self-stigma towards one's mental illness is believed to be a contributing factor undermining adherence. This study aimed at obtaining empirical support regarding the relationship between psychosocial treatment adherence and self-stigma. Other significant predictors of adherence to psychosocial interventions were to be identified. Methods: Eighty-six people with DSM IV diagnoses of schizophrenia were recruited from psychiatric hospitals and community settings in Hong Kong. Their level of stigma, self-esteem, self-efficacy, insight, psychosocial treatment adherence and demographic data were collected. Multiple regression was used to investigate the adjusted relationship between psychosocial treatment adherence and the selected independent variables. Results: Higher level of self-stigma, poorer current insight on the social consequences of having mental illness, and living with others were found to be significant predictors of poor psychosocial treatment attendance. Better self-esteem and current insight about the negative social consequences were significant predictors of better psychosocial treatment participation. Self-stigma and self-esteem exhibited the strongest contributions to psychosocial treatment adherence. Conclusions: Self-stigmatization is associated with the level of treatment adherence among people with schizophrenia, and its negative effect was found to intensify along the self-stigmatization process. Further studies to enhance understanding of self-stigma and improve treatment adherence are suggested.